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  pro-indemnity.co.uk

Let and Unoccupied Property Form

1. Your Name:

2. Correspondence address:

 Postcode:

 Telephone Number:

 E-mail:

3. Address of property to be insured:

 Postcode:

4. Buildings sum insured (rebuilding cost):

£

5. Type of property:

 Number of bedrooms:

6. Construction:

 Is property purpose built?:

 Walls (eg: brick, stone etc.):

 Roof (eg: titles, slate etc.):

 Floors (eg: wooden, concrete ):

 Any flat roof area (approx. percentage):

%

7. Year of build (approx.):

8. Is the property:

 A listed building?

Yes No

 If yes, what grade?

 Near a riverbank?

Yes No

 If yes, approx. distance from riverbank:

metres

9. Security

 Smoke Detectors fitted?:

Yes No

 Alarm fitted?:

Yes No

 If alarm fitted, please give type:

 Locks fitted on Doors & Windows?:

 Yes No

 Safe Installed?:

 Yes No

 Security Lights installed?:

 Yes No

 Neighbourhood Watch area?:

 Yes No

10. Is Property Currently occupied?:

 Yes No

 If so, type of tenants:

 Who is your tenancy agreement with?

11. Type of lease:

 Length of lease:

12. If unoccupied, please state reason:

13. Value of Landlords contents (if any):

£

14. Potential loss of rental income (if any, or cost of alternative accommodation. Note that this is normally 20% of building sum insured ):

£

15. Subsidence cover required?:

 Yes No

16. How long have you owned property?

17. Any claims?

 Yes No

If yes, please provide details

Date of claims

What happened (eg fire, theft, storm, flood)

Total Payment

1.

2.

3.

4.

18. Current insurers: (so we don't approach them)

19. Expiry date:

20. Target premium: (if known)

21. Is there a mortgage lender?

 Yes No

If "Yes" please provide name and address (if known)

Please supply me with an estimate within working days.
(We will attempt to meet the target, but please be aware that
it does require our insurers to respond quickly as well!)

Done

 

Please check your details, and when you are happy that all is correct,
tick the 'Done' box and then click the Submit button above...